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Special Needs Children

On February 1, 2020, The Illinois Department of Healthcare and Family Services (HFS) Managed Care Organizations transitioned all Special Needs Children into managed care.

Special Needs Children (SNC) Include:

  • Children receiving Supplemental Security Income (SSI)
  • Children enrolled in the Division of Specialized Care for Children (DSCC) CORE program
  • Children with a physical disability category

IlliniCare Health has committed to our members and HFS to ensure our Special Needs Children’s necessities are being addressed.

In order to do so, we have the following:

  • A team of licensed clinicians who have extensive knowledge of physical, behavioral and social supports needed by special needs children.
  • An understanding that established trusted relationships are important.  IlliniCare Health and the Division of Specialized Care for Children (DSCC) are working towards a contract to ensure that families established with the DSCC-CORE program continue to receive the right support for their child/children’s unique needs and goals. DSCC will continue to provide services during the contracting period.  More information will be provided once the contract is complete.
  • A number of in-network providers contracted that have been extended specifically for the Special Needs Children population.
  • 180-day continuity of care to make sure any out-of-network providers or services established on your child’s treatment plan will continue during the first 180-days of transition. IlliniCare Health will make every effort to contract with the provider/services during the 180-day period.

FAQs

The only Special Needs Children excluded from this transition are:

  • Medically Fragile Technology Dependent (MFTD) waiver members
  • Children who receive Nursing and Personal Care Services Program (NPCS) 
  • Children who also have TPL / commercial insurance 
  • Special Needs Children will receive all their Medicaid covered services and medical care coordination from the health plan.
  • Yes. You can change your PCP once a month. To change your PCP, call the IlliniCare Health Member Services Team at 866-329-4701.
  • If you did not choose a health plan by the deadline listed in your enrollment letters, a health plan and a PCP was be picked for you by HFS.
  • If you are in a current, ongoing course of treatment, you can continue with your provider for 180 days when first enrolling in a Health Plan. If there are any issues please call the IlliniCare Health Member Services Team at 866-329-4701 and request to speak with a member of the SNC team.
  • IlliniCare Health is committed to maintaining continuity of care for our members and understands that maintaining established relationships with treatment providers is important to stay healthy. Because of this, IlliniCare Health has contracts with additional providers just for the special needs population. If you need to confirm your provider’s network status, please call the IlliniCare Health Member Services Team at 866-329-4701.  
  • You must contact your health plan as soon as possible. IlliniCare Health will make sure to work towards a contract with the provider.